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Welcome to

today’s

webinar!

We will begin shortly…

OVERDOSE

MONITORING

AND RESPONSE

FOR ONTARIO

Michael Parkinson

overdoseprevention.ca

Overdose Monitoring And Response in Ontario

Council Membership

Police

Education Child

Welfare

Community Based Justice

Housing

Addiction

Older Adult Services

Social Services

Public Health

Planning

Neighbour- hoods

Recreation

Youth Services

Regional Council

Business Faith

Family Violence

WRCPC

Mental Health Newcomers

Media Community

We believe in:

in preventing crime by addressing the root causes

in just and humane approaches to crime and its consequences

that we are stronger working together

that the community is part of the solution

Our Values

"We speak for the dead to protect the living"

Office of the Chief Coroner of Ontario

Ontario

• Hydromorph Contin (Purdue Pharma)

– 1.6million Rx in 2014, up 60% since 2011

©MDSCNO 2015

Pharma research, production and marketing

Regulatory Approvals

Government and Private Sector Drug Benefit Plans

Rx by physicians, dentists etc.

Dispensed by pharmacists

Consumed as Rx'd – and not – by patients

Ontario 2015 1065 drug-related Deaths 1 death / 8 hours 66% involve opioids 735 opioid-related deaths 1 death / 12 hours 28% involve fentanyl First 6 months 2016: 412 fatalities

Source: Figure produced by the Waterloo Region Crime Prevention Council using data from the Office of the Chief Coroner of Ontario and the Ontario Ministry of Transportation

Urgent? Proportional? Collaborative?

SARS: 44 in Canada

Anaphylaxis: 92 in Ontario in 25 years

Ontario roadways: 481 in 2014

Ontario opioid deaths: 674 in 2014

Total opioid deaths 2000-2015: > 7,000

Bootleg Fentanyls

• Black market pills and powder

• Uncertain dosage

• Lethal at very small doses

2008

Oxy to Oxy 2:

Impacts and Recommendations Community Forum

June 11, 2012

Second Informal Summary Report

WRCPC - OACP

Opioid-related Overdose

Deaths in Waterloo Region

Year OD Decedents

2013 22

2014 22

2015* 23

First six months:

2016* 23

First four months:

2017** 28** • Data c/o Office of the Chief Coroner of Ontario

• * Preliminary data c/o Office of the Chief Coroner of Ontario

• ** Number of suspected opioid-related overdose deaths c/o Waterloo Region Police Services

• Chart c/o Waterloo Region Crime Prevention Council @drugsWRCPC

Prescription for Life June 1, 2015

Rec 4a:

The Province of Ontario and the Government of Canada to Develop Real Time and Online Monitoring and Surveillance

Decision instrument to activate an emergency control group adapted from the WHO (2008)

International Health Regulations (2005) 2nd ed.

46%

Between Life and Death:

The Barriers to Calling 9-1-1 During an

Overdose Emergency

OD MAP

HOLD SLIDE FOR RESPONSE INTERVENTIONS

Urgent?

Proportional?

Collaborative?

Michael Parkinson

Waterloo Region Crime Prevention Council

mparkinson@regionofwaterloo.ca

@drugsWRCPC

www.preventingcrime.ca

:

Interactive Opioid Tool: Visualizing Long-Term Trends in Opioid-Related Morbidity and Mortality

Karin Hohenadel, Manager (A), Communicable Diseases

June 8, 2017

PublicHealthOntario.ca

• Public Health Ontario (PHO) provides support to:

• Ministry of Health and Long-Term Care’s comprehensive opioid strategy

• Local public health units responding to opioid-related harms

• Key contributions:

• Assembling, analyzing and visualizing data on opioid-related morbidity and mortality in Ontario

• Providing scientific expertise and consultation (e.g., evidence briefs)

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Background

PublicHealthOntario.ca

Background

• Collaboration: PHO built the Opioid Interactive Tool in collaboration with the Executive Steering Committee on Surveillance, at the request of the Chief Medical Officer of Health

• Purpose: provide accurate information to stakeholders on long-term, population-level trends in opioid-related morbidity and mortality

• It is not intended to be an early warning system

• Primary uses:

• Provincial and local population health assessment

• Guide policy decisions

• Evaluate large scale interventions

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PublicHealthOntario.ca

Scope

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Morbidity

Emergency department visits

Hospitalizations

Mortality

Deaths

PublicHealthOntario.ca

Tool development

1. What type of data is available to measure opioid-related harms in Ontario?

2. What indicators have others used to measure opioid-related harms in Ontario and Canada?

3. What are the gaps and opportunities?

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Scan Appraise Discuss

PublicHealthOntario.ca

Approach

• Interactive tool allows users to explore data on opioid-related: • Emergency department visits

• Hospitalizations

• Deaths

• Users can view data by: • Public health unit

• Local health integration network

• Age

• Sex

• Drug type (for deaths only)

• Data will be updated quarterly as available

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PublicHealthOntario.ca

Data sources and indicators

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Data source Measurement Strengths, weaknesses and opportunities

National Ambulatory Care Reporting System (NACRS)

Emergency department visits attributed to “opioid poisoning”

• Quality: uses international classification of disease (ICD) codes for outcome and intention

• Timeliness: 4-6 month delay

Discharge Abstract Database (DAD)

Hospitalizations attributed to “opioid poisoning” at discharge

• Quality: uses international classification of disease (ICD) codes for outcome and intention

• Timeliness: 4-6 month delay

Office of the Chief Coroner of Ontario (OCCO)

Death: official cause of death

• Quality: detailed pathological and toxicological findings

• Timeliness: 1-2 year delay • Underway: improved timeliness, more

detailed information including socio-demographics

PublicHealthOntario.ca

QUESTIONS? CDEPR@OAHPP.CA

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Overdose Detection Mapping Application Program (ODMap) WASHINGTON/BALTIMORE HIDTA

J E F F B E E S O N , D E P U T Y D I R E C TO R

J B E E S O N @ W B . H I D TA . O R G

Overdose Epidemic Nationally, over 52,000 overdose deaths were reported in 2015

All but 9 states have recorded an increase in overdose death rates from 2014 to 2015

Preliminary data from 2016 shows another anticipated and significant increase

ODMap Concept

ODMAP provides real-time overdose surveillance across jurisdictions to support public safety and public health efforts to mobilize immediate responses to overdose spikes

It links first responders on scene to a mapping tool to track overdose spikes as they happen for response and strategic analysis

It is designed to show spikes across multiple jurisdictions

It is a mobile site that can be used in the field via any mobile device or mobile device terminal, or data can added later from any computer

Partnering agencies sign a Teaming Agreement outlining policies for system use to protect the data being reported

The general public does not have access to this system

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Please fill out our evaluation at https://www.surveymonkey.com/r/HFYBXBT To learn about upcoming events, visit the EENet Opioid Resource Hub at https://www.porticonetwork.ca/web/opioid-resource-hub/home